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PHARM 233 > Skin > Flashcards

Skin Flashcards

1
Q

Hydrocortisone
- MOA
- Adverse

A

Glucocorticoid
- Mild Potency

MOA:
- Upregulates Lipocortin
–> Inhibits Phospholipase A2
–> Reduces formation of arachidonic acid inflammatory mediators
- Inhibits DNA synthesis/mitosis of epidermal cells
- Vasoconstriction of skin
–> Reduces Itching and Redness

Adverse Effects:
- Steroid Rebound
–> Negative feedback causes Down regulation of glucocorticoid receptors. Endogenous Receptors become too low resulting in lesions coming back

  • Skin Atrophy (Skin Thinning)
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2
Q

Clobetasol Propionate
- MOA
- Adverse

A

Glucocorticoid
- Very Potent

MOA:
- Upregulates Lipocortin
–> Inhibits Phospholipase A2
–> Reduces formation of arachidonic acid inflammatory mediators
- Inhibits DNA synthesis/mitosis of epidermal cells
- Vasoconstriction of skin
–> Reduces Itching and Redness

Adverse Effects:
- Steroid Rebound
–> Negative feedback causes Down regulation of glucocorticoid receptors. Endogenous Receptors become too low resulting in lesions coming back

  • Skin Atrophy (Skin Thinning)
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3
Q

Alclometasone Dipropionate
- MOA
- Adverse

A

Glucocorticoid
- Moderate

MOA:
- Upregulates Lipocortin
–> Inhibits Phospholipase A2
–> Reduces formation of arachidonic acid inflammatory mediators
- Inhibits DNA synthesis/mitosis of epidermal cells
- Vasoconstriction of skin
–> Reduces Itching and Redness

Adverse Effects:
- Steroid Rebound
–> Negative feedback causes Down regulation of glucocorticoid receptors. Endogenous Receptors become too low resulting in lesions coming back

  • Skin Atrophy (Skin Thinning)
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4
Q

Beclomethasone Diproprionate
- MOA
- Adverse

A

Glucocorticoid
- Potent

MOA:
- Upregulates Lipocortin
–> Inhibits Phospholipase A2
–> Reduces formation of arachidonic acid inflammatory mediators
- Inhibits DNA synthesis/mitosis of epidermal cells
- Vasoconstriction of skin
–> Reduces Itching and Redness

Adverse Effects:
- Steroid Rebound
–> Negative feedback causes Down regulation of glucocorticoid receptors. Endogenous Receptors become too low resulting in lesions coming back

  • Skin Atrophy (Skin Thinning)
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5
Q

Diflucortolone Valerate
- MOA
- Adverse

A

Glucocorticoid
- Very Potent

MOA:
- Upregulates Lipocortin
–> Inhibits Phospholipase A2
–> Reduces formation of arachidonic acid inflammatory mediators
- Inhibits DNA synthesis/mitosis of epidermal cells
- Vasoconstriction of skin
–> Reduces Itching and Redness

Adverse Effects:
- Steroid Rebound
–> Negative feedback causes Down regulation of glucocorticoid receptors. Endogenous Receptors become too low resulting in lesions coming back

  • Skin Atrophy (Skin Thinning)
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6
Q

Tretinoin
- MOA
- Treats
- Adverse

A

Retinoid
- RAR Agonist
- RXR Agonist

Treats:
- Acne
- Eczema
- Psoriasis

Adverse Effects
- Skin Peeling (Too much growth factors)
- Teratogenic (Vit A has narrow therapeutic window)

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7
Q

Isotretinoin
- MOA
- Treats
- Adverse

A

Retinoid
- RAR Agonist
- RXR Agonist

Treats:
- Acne
- Eczema
- Psoriasis

Adverse Effects
- Skin Peeling (Too much growth factors)
- Teratogenic (Vit A has narrow therapeutic window)

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8
Q

Alitretinoin
-MOA
-Treats
-Adverse

A

Retinoid
- RAR Agonist
- RXR Agonist

Treats:
- Acne
- Eczema
- Psoriasis

Adverse Effects
- Skin Peeling (Too much growth factors)
- Teratogenic (Vit A has narrow therapeutic window)

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9
Q

Tazarotene
-MOA
-Treats
-Adverse

A

Retinoid
- RAR Agonist
- RXR Agonist

Treats:
- Acne
- Eczema
- Psoriasis

Adverse Effects
- Skin Peeling (Too much growth factors)
- Teratogenic (Vit A has narrow therapeutic window)

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10
Q

Bexarotene

A

Third Generation Retinoid
- More potent for RXR than RAR

Blocks Cell Cycle Progression
–> Induces apoptosis
–> Inhibits angiogenesis

Treats:
- Treats Cutaneous T-Cell Lymphoma

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11
Q

Retinoid
- MOA

A

Derived from Vitamin A

Retinoic Acid Receptor Agonists (RAR)
and
Retinoid X Receptor Agonists (RXR)

Transcription Factors that induce/repress gene transcription

  • Anti-inflammatory Actions
  • Reduce sebaceous gland & sebum production
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12
Q

Calcitriol

A

Vitamin D Analogue
- Vitamin D Nuclear Receptor Agonist

MOA:

Reduce Keratinocytes:
- Reduces proliferation of Keratinocytes
- Increase apoptosis of Keratinocytes

Reduce Inflammatory Action:
- Inhibit T Cell Activation

Treats:
- Psoriasis

Adverse Effects:
- Hypercalcemia (Excess Vitamin D will activate osteoclasts which pulls calcium from bone into circulation)

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13
Q

Calcipotriol
-MOA
-Treats
-Adverse

A

Vitamin D Analogue
- Vitamin D Nuclear Receptor Agonist

MOA:

Reduce Keratinocytes:
- Reduces proliferation of Keratinocytes
- Increase apoptosis of Keratinocytes

Reduce Inflammatory Action:
- Inhibit T Cell Activation

Treats:
- Psoriasis

Adverse Effects:
- Hypercalcemia (Excess Vitamin D will activate osteoclasts which pulls calcium from bone into circulation)

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14
Q

Tacalcitol
-MOA
-Treats
-Adverse

A

Vitamin D Analogue
- Vitamin D Nuclear Receptor Agonist

MOA:

Reduce Keratinocytes:
- Reduces proliferation of Keratinocytes
- Increase apoptosis of Keratinocytes

Reduce Inflammatory Action:
- Inhibit T Cell Activation

Treats:
- Psoriasis

Adverse Effects:
- Hypercalcemia (Excess Vitamin D will activate osteoclasts which pulls calcium from bone into circulation)

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15
Q

Salicylic Acid
- MOA

A

Keratolytic
- Breaks down Keratin in the skin reducing thickness of stratum corneum
–> Solubilizes protein components of desmosomes that links cells together
–> Activates endogenous hydrolytic enzymes within stratum corneum (Increases Acid Secretion)
–> Diffuse into stratum corneum to increase water content to physically move wart from tissue

Should not be used on open wounds

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16
Q

Glycolic Acid
- MOA

A

Keratolytic
- Breaks down Keratin in the skin reducing thickness of stratum corneum
–> Solubilizes protein components of desmosomes that links cells together
–> Activates endogenous hydrolytic enzymes within stratum corneum (Increases Acid Secretion)
–> Diffuse into stratum corneum to increase water content to physically move wart from tissue

Should not be used on open wounds

17
Q

Keratolytics
- Used to Treat

A

Warts

18
Q

Cryotherapy
- MOA

A

Removes warts by freezing

19
Q

Imiquimod
- Treats?

A

Anogenital Warts

20
Q

Imiquimod
- MOA

A

Enhances innate and acquired immune response
- Binds toll-like receptors on B cells
- Increases release of inflammatory mediators (TNFa and Interleukins)
–> Activates immune system to get rid of rouge keratinocytes causing warts

21
Q

Cyclosporine
- MOA

A

Immunosuppressant
- Used when glucocorticoids prove ineffective

Cyclic Peptide, binds to cyclophilin and inhibits calcineurin
–> Decreases IL-2 synthesis
–> Decrease Proliferation of T Cells

Treats:
- Serious Eczema
- Serious Psoriasis

22
Q

Cyclosporine
- Adverse Effects

A
  • Nephrotoxicity (Not caused by immunosuppressant action)
  • Hepatotoxicity
  • Hypertension
23
Q

Role of Calcineurin

A

Increased intracellular Ca2+
–> Activates Calcineurin, which dephosphorylates the nuclear factor of activated T Cells (NFAT)

  • NFAT binds to response elements
    –> Turns on transcription of IL-2 leading to T-Cell activation
24
Q

Calcineurin Inhibition

A

Calcineurin is inhibited
- Calcineurin can not dephosphorylate NFAT
–> Can not turn on transcription and production of IL-2

  • Only works on T-Cells that have not been activated yet
25
Q

Tacrolimus
- MOA
- Treats
- Adverse

A

Macrolide, inhibit calcineurin
- Decreases IL-2 synthesis
- Decrease proliferation of T-Cells

Treats:
- Serious Eczema
- Serious Psoriasis

Adverse Effects:
- Alopecia (Hair Loss)
- Hyperglycemia

26
Q

Pimecrolimus
-MOA
-Treats
-Adverse

A

Macrolide, inhibit calcineurin
- Decreases IL-2 synthesis
- Decrease proliferation of T-Cells

Treats:
- Serious Eczema
- Serious Psoriasis

Adverse Effects:
- Hyperglycemia

27
Q

4 Kinds of Cytokines

A

Interleukins
Chemokines
Interferons
Colony Stimulating Factors

28
Q

Interleukins

A

Pro-Inflammatory
- TNFa
- IL-1a/b

Anti-Inflammatory
- IL-4, IL-10, IL-13

29
Q

Chemokines

A

MCP-1, RANTES (C-C), CXCL-12 (C-X-C)

30
Q

Interferons

A

IFNa: Chronic Hepatitis B & C & Malignant Disease
IFNB: Relapsing Multiple Sclerosis
IFN Gamma: Immunodeficiency disease to reduce infection (Chronic Granulomatous Disease)

31
Q

Colony Stimulating Factors

A

Cytokines/Overlap Growth Factors

32
Q

Infliximab

A

Chimeric Neutralizing Antibody
- Targets TNFa

Prevents release of inflammatory cytokines
Prevents adhesion of leukocytes to target organs

Treats:
- Psoriasis

33
Q

Adalimumab

A

Humanized Monoclonal Antibody
- Targets TNFa

Prevents release of inflammatory cytokines
Prevents adhesion of leukocytes to target organs

Treats:
- Psoriasis

34
Q

Secukinumab

A

Monoclonal Antibody
- Targets IL-17

Reduces Inflammation
Newer Psoriasis Treatment

35
Q

Ixekizumab

A

Monoclonal Antibody
- Targets Homodimers of IL-17A

Reduces Inflammation
Newer Psoriasis Treatment

36
Q

Ustekinumab

A

Monoclonal Antibody
- Targets IL-12 and IL-23

Reduces Inflammation
Newer Psoriasis Treatment

PHARM 233 (10 decks)

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